Individual provider Active NPI

R Garth Harris, D.D.S.

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1164439444
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3208 Issued in NV
Practice address
9777 Bermuda Rd Ste 100
Las Vegas, NV 89183-3571
Phone
(702) 324-0404
Fax
(702) 914-9019
NPI assigned
Aug 1, 2006
Last updated
Nov 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3208 NV Primary

Addresses

Primary practice location

9777 Bermuda Rd Ste 100
Las Vegas, NV 89183-3571

Mailing address

9777 Bermuda Rd
Ste 100
Las Vegas, NV 89183-3571
Phone (702) 699-5551

Other names 1

  • Rodney Garth Harris Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160408000731 NV Order and Referring Only - DentistPractitioner - Dentist 3274831151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3208NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Paradise Dental LLC Past Accepting new patients
Jenkins Dental Partners PC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1164439444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9777 BERMUDA RD",
            "address_2": "STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891833571",
            "telephone_number": "702-699-5551",
            "fax_number": "702-914-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 BERMUDA RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891833571",
            "telephone_number": "702-324-0404",
            "fax_number": "702-914-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "R GARTH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "3208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RODNEY",
            "last_name": "HARRIS",
            "middle_name": "GARTH",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.